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Cephalexin (cephalexin)




Cephalosporin (1st generation)




Treatment of otitis media, skin and skin structure infection, and bone, genitourinary tract (eg, prostatitis), and respiratory tract infections caused by susceptible strains of microorganisms.


General Dosing

Usual: 250mg q6h
Range: 1-4g/day in divided doses

May need larger doses in more severe infections or those caused by less susceptible organisms; if doses >4g/day are required, consider parenteral cephalosporins


>15 Years:
Streptococcal: 500mg q12h

Skin and Skin Structure Infections

>15 Years:
500mg q12h

Uncomplicated Cystitis

>15 Years:
500mg q12h for 7-14 days

Other Indications

Treatment of the Following Infections Caused by Susceptible Microorganisms:
Respiratory tract infections
Bone infections
Genitourinary tract infections
Otitis media


General Dosing

Usual: 25-50mg/kg/day in divided doses; may double the dosage in severe infections

β-Hemolytic Streptococcal Infections: Administer for at least 10 days


25-50mg/kg/day in divided doses
>1 Year: May divide total daily dose q12h

Skin and Skin Structure Infections

Usual: 25-50mg/kg/day in divided doses; may give q12h

Otitis Media

75-100mg/kg/day in 4 divided doses


Oral route

Take w/o regard to meals.

Shake well before use.
After mixing, store in refrigerator; may be kept for 14 days w/o significant loss of potency.

Add to the bottle a total of 71mL (for 100mL when mixed) or 140mL (for 200mL when mixed) of water in 2 portions.
250mg/5mL: Add to the bottle a total of 71mL (for 100mL when mixed) or 140mL (for 200mL when mixed) of water in 2 portions.


Cap: 250mg, 500mg, (Keflex) 250mg, 500mg, 750mg; Sus: 125mg/5mL [100mL, 200mL], 250mg/5mL [100mL, 200mL]; Tab: 250mg*, 500mg* *scored


Caution in penicillin (PCN)-sensitive patients; cross-hypersensitivity among β-lactam antibiotics may occur. D/C use if an allergic reaction occurs and institute appropriate therapy. Clostridium difficile-associated diarrhea (CDAD) reported; may need to d/c if CDAD is suspected or confirmed. May result in bacterial resistance w/ prolonged use or use in the absence of a proven/suspected bacterial infection or a prophylactic indication; take appropriate measures if superinfection develops. Perform indicated surgical procedures in conjunction w/ antibiotic therapy. Caution in patients w/ markedly impaired renal function or history of GI disease, particularly colitis. May cause a fall in prothrombin activity; monitor PT in patients at risk (eg, hepatic/renal impairment, poor nutritional state, patients on protracted course of antimicrobial therapy, patients previously stabilized on anticoagulant therapy) and administer vitamin K as indicated. Lab test interactions may occur. Caution in elderly.


Diarrhea, allergic reactions, dyspepsia, gastritis, abdominal pain.


Probenecid inhibits renal excretion. Concomitant use w/ metformin may increase levels of metformin and produce adverse effects; monitor patient closely and adjust dose of metformin accordingly.


Category B, caution in nursing.


Cephalosporin (1st generation); bactericidal activity results from its inhibition of cell-wall synthesis.


Absorption: Rapid. Cmax=9mcg/mL (250mg), 18mcg/mL (500mg), 32mcg/mL (1g); Tmax=1 hr. Distribution: Found in breast milk. Elimination: Urine (90% unchanged).


Assess for previous hypersensitivity to cephalosporins, PCNs, or other drugs. Assess renal/hepatic function, for a history of GI disease, pregnancy/nursing status, and for possible drug interactions. Obtain baseline culture and susceptibility tests.


Monitor for signs/symptoms of hypersensitivity reactions, CDAD, superinfection, and other adverse reactions. Monitor PT and renal function when indicated. Perform culture and susceptibility tests.


Inform that drug only treats bacterial, not viral, infections. Instruct to take exactly ud; inform that skipping doses or not completing full course of therapy may decrease effectiveness and increase bacterial resistance. Inform that diarrhea may be experienced as late as ≥2 months after last dose; counsel to contact physician if watery/bloody stools (w/ or w/o stomach cramps and fever) occur.


20-25°C (68-77°F). (Sus) Store in refrigerator after mixing. May be kept for 14 days w/o significant loss of potency. Keep tightly closed. (Keflex) 25°C (77°F); excursions permitted to 15-30°C (59-86°F).


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